Provider Demographics
NPI:1619215373
Name:LOOMIS, NORMAN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:RICHARD
Last Name:LOOMIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7736 TAMARACK LN
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:NY
Mailing Address - Zip Code:14519-9536
Mailing Address - Country:US
Mailing Address - Phone:315-524-6501
Mailing Address - Fax:315-524-6501
Practice Address - Street 1:7736 TAMARACK LN
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:NY
Practice Address - Zip Code:14519-9536
Practice Address - Country:US
Practice Address - Phone:315-524-6501
Practice Address - Fax:315-524-6501
Is Sole Proprietor?:No
Enumeration Date:2013-01-30
Last Update Date:2013-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073888-1207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine